Search Results (100)

Objectives: This study aimed to analyse the haematological parameters in relation to subjective tinnitus. We hypothesise that abnormal haematological findings may correlate with increased severity and chronicity of tinnitus. This research could lead to improved diagnostic methods and more targeted treatments. Material and Methods: A total of 439 patients with primary subjective tinnitus and 274 individuals without tinnitus were enrolled. These participants underwent comprehensive laboratory testing, which included haematological parameters. Results: When comparing the white blood cell levels between the tinnitus group and the control group, no statistically significant differences were found (p = 0.743). Similarly, comparisons of red blood cell levels (p = 0.250), haemoglobin levels (p = 0.087), and haematocrit levels (p = 0.066) also revealed no significant differences. The platelet levels showed no significant difference between the two groups (p = 0.782). According to a logistic regression model, lower levels of haemoglobin (p = 0.000) and platelets (p = 0.000) significantly predicted higher scores on the Tinnitus Handicap Inventory, indicating self-reported tinnitus severity. Furthermore, lower haemoglobin levels were significant predictors (p = 0.04) of developing bilateral tinnitus. Using Spearman’s correlation test, a statistically significant negative correlation (p = 0.029) was observed between red blood cell levels and the onset of tinnitus. The frequency of tinnitus demonstrated a significant positive correlation with haemoglobin levels (p = 0.04) and haematocrit levels (p = 0.043). Conversely, platelet levels showed a significant negative correlation with both tinnitus intensity (p = 0.002) and the onset of tinnitus (p = 0.033). Conclusions: While the haematological parameters showed no significant differences between the tinnitus and control groups, further analyses indicated that certain parameters, such as haemoglobin and haematocrit levels, could potentially influence tinnitus, necessitating further investigation. Full article

Ménière’s Disease (MD) is a chronic inner ear disorder defined by recurring episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, and/or fullness in the ear. Its prevalence varies by region and ethnicity, with scarce epidemiological data in the Brazilian population. Although most MD cases are sporadic, familial MD (FMD) is observed in 5% to 20% of European cases. Through exome sequencing, we have found a rare missense variant in the OTOG gene in a Brazilian individual with MD with probable European ancestry (chr11:17599671C>T), which was previously reported in a Spanish cohort. Two additional rare missense heterozygous OTOG variants were found in the same proband. Splice Site analysis showed that chr11:17599671C>T may lead to substantial changes generating exonic cis regulatory elements, and protein modelling revealed structural changes in the presence of chr11:17599671C>T, chr11:17576581G>C, and chr11:17594108C>T, predicted to highly destabilize the protein structure. The manuscript aims to replicate genes previously reported in a Spanish cohort, and the main finding is that a Brazilian patient with MD also has variants previously reported in familial MD, supporting OTOG as the most frequently mutated gene in MD. Full article

Objectives: This study aimed to analyse blood glucose and lipid levels in subjective tinnitus compared to healthy controls. Method: A total of 414 patients with subjective tinnitus and 274 healthy participants were enrolled. All participants underwent comprehensive laboratory testing, which included measurements of fasting blood glucose, HbA1c, and blood lipids. Results: The tinnitus group had significantly higher glucose levels than the control group (p = 0.024). Additionally, the HbA1c levels were higher in the tinnitus group (p = 0.006). Tinnitus patients exhibited elevated levels of total cholesterol (p < 0.001), triglycerides (p < 0.001), and LDL (p < 0.001). However, HDL levels showed no significant difference (p = 0.984). Although the triglyceride–glucose index tends to show higher values in the tinnitus group, this difference is statistically insignificant (p = 0.688). ROC indicated that LDL had the highest sensitivity for predicting tinnitus (AUC = 0.620; p < 0.001, 95% CI: 0.573–0.668). Other parameters showed significant results, excluding the triglyceride–glucose index (AUC = 0.514; p = 0.688, 95% CI: 0.443–0.585), which was not a significant predictor. Glucose levels significantly correlate with age (rho = 0.338, p < 0.001) and tinnitus onset (rho = 0.107, p = 0.034). Additionally, age showed a significant correlation with total cholesterol levels (rho = 0.156, p = 0.002) and triglycerides (rho = 0.121, p = 0.020) and tinnitus onset (rho = 0.344, p < 0.001). Logistic regression analysis revealed that the presence of tinnitus was significantly associated with elevated HbA1c levels (p = 0.007) and TG levels (p = 0.001). Furthermore, the occurrence of chronic tinnitus was significantly influenced by elevated glucose levels (p = 0.026). Conclusions: The results showed increased glucose and blood lipid levels in tinnitus. LDL levels exhibited the highest sensitivity in predicting tinnitus. However, the TyG index was not a significant predictor. Given the cross-sectional design of the study, which may limit the results, further longitudinal studies are necessary. Full article

Tinnitus is defined as the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes tinnitus disorder when the phantom sound is associated with suffering and/or disability. There is only limited knowledge about the time course of tinnitus disorder. Bereavement science has identified four different trajectories: resilience, recovery, chronic, and delayed. The question arises whether these four trajectories exist in tinnitus as well if one considers tinnitus as the loss of silence (at will). To verify whether these four trajectories exist, short-term tinnitus progression was analyzed retrospectively using an Ecological Momentary Assessment (EMA) approach, extracting the data from patients who started using the TrackYourTinnitus (TYT) app (version 1, Ulm University, 2013) from the start of their tinnitus perception. Four patients were identified retrospectively via the TYT app with acute tinnitus, and the bereavement trajectories were reconstructed based on EMA. In conclusion, this perspective suggests that the four known bereavement trajectories may exist in tinnitus, and prospective evaluations of larger samples are warranted to confirm or disprove this analogy between bereavement and tinnitus, in which tinnitus is conceived as the loss of (controllable) silence. Full article

Background and Objectives: The management of chronic tinnitus in patients with otosclerosis presents a considerable clinical challenge, particularly as to those who are either ineligible for or reluctant to undergo surgical interventions. Surgical interventions improve hearing levels and may provide relief from tinnitus; however, medical research is also focused on alternative non-surgical treatments aimed at symptomatic improvement. This is particularly relevant, considering that otosclerosis currently has no definitive cure, despite the existence of various surgical techniques and oral therapies. This study evaluates the effects of oral calcium and fluoride supplementation on tinnitus severity in otosclerosis patients who opted for non-surgical management. Materials and Methods: A total of 128 otosclerosis patients with tinnitus were included in this study, which was conducted over a five-year period. Patients were categorized into three groups based on the severity of their tinnitus (mild, moderate and severe), as assessed by the Tinnitus Handicap Inventory (THI). Patients in all three groups received Florical (Mericon Industries, Inc., Peoria, IL, USA), a calcium and fluoride supplement, and were monitored over three months. The severity of tinnitus was reassessed following supplementation. Statistical analyses were conducted to further investigate patient scores. Results: Evaluating patients based on the severity of their tinnitus, we consistently observed clinically significant reductions in THI scores, specifically a decrease of 10 points or more, among those with mild tinnitus. The moderate group exhibited a lower degree of reduction in their THI scores, while the severe group appeared to be unaffected. Statistical analyses reveal a significant correlation between the reduction of tinnitus and the supplementation of Florical, as the severity of tinnitus decreases. Conclusions: The present study suggests that oral calcium and fluoride supplementation may serve as a promising non-surgical approach for tinnitus management in otosclerosis (particularly in patients with mild symptoms), in addition to its marketing-indicated role, supporting the preservation of hearing levels in otosclerosis. Its efficacy seems to diminish as tinnitus severity increases, further pointing out a potential preventative role of this supplementation. Full article

Objectives: This study aimed to analyse the potential influence of abnormalities detected through carotid–vertebral ultrasonography and brain MRI on pure-tone averages (PTAs) and the frequency and intensity of tinnitus. Methods: 423 participants with subjective tinnitus were enrolled in this investigation. All patients underwent carotid– vertebral ultrasonography, brain MRI, and pure-tone audiometry, including tinnitus matching. Results: The median values for tinnitus onset indicated chronic tinnitus in most cases. Regarding tinnitus location, left-sided symptoms (32%) and bilateral symptoms (44%) were the most prevalent. In analysing the effects of abnormalities detected by carotid–vertebral ultrasonography on PTAs, a statistically significant difference was found between the groups (p = 0.0037). Specifically, individuals with intimal hyperplasia had significantly higher PTAs (p = 0.02), as did those with carotid artery plaques (p = 0.005). However, no significant differences in PTAs were noted in relation to carotid artery stenosis (p = 0.07). Similar trends emerged regarding tinnitus intensity (p = 0.013), with significantly higher values observed in the presence of any carotid–vertebral ultrasonography abnormalities. In contrast, tinnitus frequencies were not significantly affected (p = 0.401). Regarding brain MRI findings, Fazekas scores of 2 (p = 0.02) and 3 (p = 0.0052) significantly influenced PTAs. For tinnitus intensity, Fazekas scores of 2 (p = 0.0027) and 3 (p = 0.0005), and the presence of acoustic neuromas (p = 0.019), significantly impacted the intensity values. However, tinnitus frequencies were not significantly (p = 0.36) influenced by brain MRI abnormalities. Conclusions: The findings of this study show that carotid–vertebral ultrasonography and brain MRI abnormalities significantly influence PTAs and tinnitus intensities. Full article

Objectives: This study aimed to explore the demographic and clinical features of tinnitus individuals and analyse its correlation with associated comorbidities. Methods: The study population comprised 147 participants (66 men, 81 women; median age: 52 years) who experienced persistent tinnitus. Comprehensive assessments were carried out, including audiological examinations, scoring using the Tinnitus Handicap Inventory, and thorough medical evaluations. Statistical analyses were applied to explore the correspondences between tinnitus, hearing loss, and various comorbidities, including cardiovascular conditions, metabolic disorders, gastroesophageal reflux disease, autoimmune diseases, pulmonary diseases, and allergic rhinitis. Results: The analysis indicated a slight predominance of females, comprising 55.1% of the participants, with a median onset of tinnitus around the age of 50. Chronic tinnitus was noted, lasting approximately 46 months. Hearing loss was noted in 52.4% of patients, with bilateral tinnitus being the most prevalent type, affecting 44.2% of individuals. Dyslipidaemia was found to significantly predict bilateral tinnitus (p = 0.003*) and left-sided tinnitus (p = 0.023*). Additionally, atherosclerosis was associated with hearing impairment (p = 0.006*) and right-sided tinnitus (p = 0.044*). Dyslipidaemia was also significantly correlated with elevated intensity values (p = 0.04*). Furthermore, atherosclerosis was significantly associated with higher levels of hearing loss (p < 0.00001*). Conclusions: The study emphasises the complex nature of tinnitus and its links to cardiovascular, metabolic, and other comorbidities, highlighting the necessity for comprehensive, interdisciplinary management. Full article

Background: Tinnitus can significantly impact a patient’s quality of life. As no evidence-based curative treatments exist, therapies such as cognitive behavioral therapy, tinnitus retraining therapy, acceptance and commitment therapy, and mindfulness-based interventions aim to minimize tinnitus severity and have been shown effective. Since traditional delivery can be costly and time-consuming and often has limited accessibility, therapies might also be provided via eHealth. This study investigates the change in tinnitus severity measured by the Tinnitus Functional Index (TFI) score after participation in an online self-paced tinnitus (“Still Tinnitus”) course. The secondary aim was to identify predictors for the clinically relevant improvement after participation in this course. Methods: This retrospective record study included patients from Still Tinnitus course between March 2023 and July 2024. Patients were recruited via the Still Tinnitus website. Differences in the TFI scores from baseline and after completing the fifth (last) module of the course were calculated to investigate the change in tinnitus over time. Multivariate logistic analyses were performed to identify the possible predictors for the clinically relevant improvement after completion of the Still Tinnitus course. Results: In total, 122 patients were included in the study. The analysis revealed a clinically relevant reduction in the TFI score of 27.2 points. Multiple regression analyses showed that the “duration of the tinnitus” (OR 5.0; 95%CI: 1.537–16.240; p = 0.007) and “female sex” (OR 1.9; 95%CI 0.111–7.637; p = 0.030) are predictors for a clinically relevant improvement. Conclusions: In a convenience sample of tinnitus patients, the Still Tinnitus course may contribute to a clinically relevant reduction in tinnitus severity. A shorter duration of tinnitus and female sex were identified as significant predictors. Full article

Background: This study investigates electrophysiological distinctions in auditory evoked potentials (AEPs) among individuals with chronic subjective tinnitus, with a specific focus on the impact of treatment response and tinnitus localisation. Methods: Early AEPs, known as Auditory Brainstem Responses (ABR), and middle AEPs, termed Auditory Middle Latency Responses (AMLR), were analysed in tinnitus patients across four clinical centers in an attempt to verify increased neuronal activity, in accordance with the current tinnitus models. Our statistical analyses primarily focused on discrepancies in time–domain core features of ABR and AMLR signals, including amplitudes and latencies, concerning both treatment response and tinnitus laterality. Results: Statistically significant differences were observed in ABR wave III and V latencies, ABR wave III peak amplitude, and AMLR wave Na and Nb amplitudes when comparing groups based on their response to treatment, accompanied by varying effect sizes. Conversely, when examining groups categorised by tinnitus laterality, no statistically significant differences emerged. Conclusions: These results provide valuable insights into the potential influence of treatment responses on AEPs. However, further research is imperative to attain a comprehensive understanding of the underlying mechanisms at play. Full article

Background: Tinnitus is a frequent symptom, and is present in 10–15% of people who suffer from chronic tinnitus, defined as heard every day for at least 6 months. Among these, 1–2% develop a strong emotive reaction, anxiety, and depression, leading to poor quality of life. Objectives: to evaluate the comorbidities in tinnitus sufferers. Methods: In our retrospective study, we collected data on 1156 subjects with tinnitus present for at least 3 months, including age, audiometric exam, THI questionnaire, vascular disorders, fluctuations, causal factors, lifetime psychiatric disorders, and the presence of migraine. A linear regression model was used to assess the independent role of these variables on the THI total score representing tinnitus annoyance. A lifetime history of psychiatric disorders and migraine were predictive for the development of a disabling tinnitus. Results: Among comorbidities a history of previous psychiatric disorders was predictive for developing tinnitus. Moreover, no correlation has been found between hearing level and THI total score. Conclusions: Our data are not inconsistent with the hypothesis that psychological disorders and a particular personality trait may be the main causal factors for tinnitus annoyance. Full article

Background/Objectives: Over the past few decades, many studies have been conducted to explore the link between tinnitus and lipid metabolism, yielding inconsistent results. In our current study, we compared the prevalence of various lipid metabolism abnormalities in patients with chronic subjective idiopathic tinnitus (CSIT) to the official prevalence data of dyslipidaemia in the general adult Hungarian population. To counteract the distorting effect of the co-increase in both conditions with age, we also examined this relationship by age groups. Methods: A total of 231 adult patients, suffering from CSIT, who underwent rheological treatment at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Center (University of Debrecen, Debrecen, Hungary), were involved in a retrospective study. Total cholesterol, serum triglycerides, LDL-C, ApoB, HDL-C, ApoA, and Lp(a) were utilized. Results: For the aggregated data, we found that the occurrence of dyslipidaemia among our patients (78.35%) significantly exceeded the corresponding official data about the occurrence of dyslipidaemia in the whole adult Hungarian population (16.51%). This finding was supported by our age-specific approach and the results imply an association between CSIT and dyslipidaemia. This finding suggests an association between CSIT and dyslipidaemia. Conclusions: Considering the relationship between CSIT and dyslipidaemia suggested by our results, tinnitus could be an indicator of dyslipidaemia, even at a young age. Therefore, careful investigation of each tinnitus patient, along with a lipidological evaluation for those with CSIT, may be recommended. This approach could lower mortality from lipid-related diseases, particularly atherosclerosis and its complications, by serving as the first line of defence against a harmful and life-threatening lipid-related conditions. Full article

Tinnitus is correlated with anomalies of neural plasticity and has been found to be affected by inflammatory status. The current theories on tinnitus, although still somewhat incomplete, are based on maladaptive plasticity mechanisms. Astrocytes play a major role in both neural responses to inflammation and plasticity regulation; moreover, they have recently been discovered to encode “context” for neuronal circuits, which is similar to the “expectation” of Bayesian brain models. Therefore, this narrative review explores the possible and likely roles of astrocytes in the neural mechanisms leading to acute and chronic tinnitus. Full article

Objectives: The aim of this study was to investigate the relationships between tinnitus pitch and loudness, the frequency of hearing loss, hearing level, and the Tinnitus Handicap Inventory (THI) scores reported by patients. Methods: In total, 139 patients (50 men and 89 women; mean age ± SD, 60.19 ± 11.47 years) who suffered from chronic primary tinnitus associated with sensorineural hearing loss were included in the study. Participants underwent pure-tone audiometry and tinnitus pitch matching assessments. Additionally, all participants completed the Hungarian version of the THI questionnaire. Correlations were assessed using simple linear, Spearman’s, and Pearson’s correlation tests, and a linear regression model was applied. The Mann–Whitney U test was also used. Results: This study identified a significant correlation between the pitch of tinnitus and the frequency of hearing loss (p = 0.000 *; rho = 0.549). There was also a significant correlation between tinnitus noise and hearing levels (p = 0.000 *; rho = 0.375). Age was shown to significantly affect tinnitus loudness (p = 0.016 *) and hearing levels (p = 0.000 *) as determined by a linear regression model. Tinnitus duration only significantly influenced tinnitus loudness (p = 0.022). There was no significant effect of sex on tinnitus or audiometry parameters. Total THI scores were influenced solely by tinnitus loudness (p = 0.021 *). Furthermore, sex did have an effect on total THI scores, with women reporting higher scores (p = 0.000 *). Conclusions: This study concluded that there is a significant correlation between the pitch and loudness of tinnitus and hearing levels, suggesting a connection in their underlying mechanisms. The intensity of tinnitus and hearing level are primarily affected by ageing processes. Furthermore, the severity of self-perceived tinnitus is mainly related to the loudness of tinnitus. Full article

Background: Somatic tinnitus (ST) is a type of tinnitus that is influenced by changes in somatosensory input from the cervical spine or temporomandibular area. Although traditional physiotherapy has been shown to reduce ST symptoms, in-clinic treatment is not always available, and adherence to home exercise programs is often low. This study aims to investigate the effectiveness of an app-based physiotherapy program to enhance the compliance and availability of treatment for ST patients. Methods: This pilot randomised controlled trial included 38 adult patients with chronic somatic tinnitus. Participants were randomly assigned to a treatment group receiving a 9-week app-based cervical spine exercise program or a control group. The primary outcome was tinnitus distress measured using the Tinnitus Handicap Inventory (THI). As a secondary outcome we used the Mini-Tinnitus Questionnaire (Mini-TQ). Results: Participants in the treatment group showed significant reductions in tinnitus distress, with a large effect size for both the THI and Mini-TQ groups (Cohen’s d = 1.71 and 1.02, respectively). The control group showed no significant changes. Conclusions: This study provides evidence that an app-based physiotherapy intervention is a feasible and effective treatment for ST. Further research with larger sample sizes and comparisons to traditional in-clinic treatments is needed to confirm these findings. Additional studies on personalised treatment might further improve the treatment. Full article

Meniere’s disease (MD) is a chronic inner ear disorder characterized by tinnitus, ear fullness, episodic vertigo, and fluctuating hearing loss, which significantly impacts quality of life and poses management challenges. Recent evidence suggests that upper respiratory infections (URIs) may contribute to MD’s onset. This study examines the potential link between URIs and MD using data from the Korean National Health Insurance Service-National Sample Cohort (2002–2019). We analyzed 19,721 individuals with MD and 78,884 matched controls, adjusting for demographic factors and comorbidities using propensity score matching. Our results showed that individuals with a URI within one year prior to the index date exhibited a 2.01-fold greater likelihood of developing MD (95% confidence interval [CI] = 1.91–2.11, p < 0.001), while those with URIs within two years demonstrated a 1.54-fold higher probability (95% CI = 1.50–1.59, p < 0.001). Furthermore, we found that even remote URIs occurring up to two years before the index date significantly increased the risk of developing MD, underscoring the need for long-term patient follow-up. Overall, our study suggests that individuals with a history of URI may have an elevated risk of developing MD over multiple time frames, regardless of demographic or health profiles. Full article